Joining the discussion about hospitals' extended use of observation status, the Department of Health and Human Services' Office of Inspector General (OIG) has issued a memorandum report that describes the nationwide use of observation and … [Read more...] about Observation Status: OIG Provides an Analysis and CMS Issues Final Regulations
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Observation Status: “Morphed Into Madness”
Although a large and increasing number of Senators and Representatives now support bipartisan legislation to solve the problem of Observation Status, many beneficiaries and their families continue to face this outpatient status as a barrier to … [Read more...] about Observation Status: “Morphed Into Madness”
Senate Hearing on Oversight of Recovery Audit Contractors: Center’s Statement Regarding Beneficiary Impact
PROGRAM INTEGRITY: OVERSIGHT OF RECOVERY AUDIT CONTRACTORSUnited States Senate Committee on Finance Hearing June 25, 2013Statement Submitted by the Center for Medicare Advocacy, Inc.The Senate Finance Committee’s June 25 hearing … [Read more...] about Senate Hearing on Oversight of Recovery Audit Contractors: Center’s Statement Regarding Beneficiary Impact
CMS Addresses Observation Status Again… And Again, No Help for Beneficiaries
As part of the annual update to inpatient hospital reimbursement under the Medicare program, the Centers for Medicare & Medicaid Services (CMS) is again considering observation status. This time CMS is proposing "a time-based … [Read more...] about CMS Addresses Observation Status Again… And Again, No Help for Beneficiaries
The Impact of the President’s Budget on People Who Depend on Medicare and Social Security
Yesterday, President Obama unveiled his Fiscal Year 2014 Budget.[1] It contains significant changes to the Medicare program – including some that would strengthen the program's fiscal stability, and some that would weaken the … [Read more...] about The Impact of the President’s Budget on People Who Depend on Medicare and Social Security
CMS’ Proposed Rules on Observation Status Would Not Help Beneficiaries
The Center for Medicare & Medicaid Services (CMS) recently issued proposed rules and an interim CMS Ruling to allow hospitals to bill Medicare Part B after a Part A claim is denied. 78 Fed. Reg. 16,632 (March 18, 2013).[1] These … [Read more...] about CMS’ Proposed Rules on Observation Status Would Not Help Beneficiaries
Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials
Introduction Checklist for Skilled Nursing Facility (SNF) Appeals Quick Screen: Should My SNF Care Be Covered By Medicare? Skilled Nursing Facility Appeal Details Additional Information The “Improvement Standard” … [Read more...] about Self-Help Packet for Skilled Nursing Facility Appeals Including “Improvement Standard” Denials
Jimmo v. Sebelius: Federal Settlement Invalidated Medicare Improvement Requirement
Based on an article by Judith A. Stein, Executive Director, Center for Medicare Advocacy, Copyright © 2013 Bloomberg BNA (2/2013).Mrs. “P” was 68 years old and living with Amyotrophic Lateral Sclerosis (ALS, commonly known as Lou … [Read more...] about Jimmo v. Sebelius: Federal Settlement Invalidated Medicare Improvement Requirement
Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
Here’s the Issue Expedited Medicare appeals and standard Medicare appeals are designed to address different things and there are situations where a Medicare beneficiary must pursue both types of appeals.Expedited Appeals – … [Read more...] about Expedited v. Standard Medicare Appeals: Not Knowing the Difference Could Cost You Your Appeal Rights!
CMS Clarifies When the Advance Beneficiary Notice of Non-Coverage (ABN) Must be Issued
August 16, 2012 On June 1, 2012, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal No.R2480CP, which updates its instructions on the issuance of the Advance Beneficiary Notice (ABN), Form CMS-R-131.[1] The changes are … [Read more...] about CMS Clarifies When the Advance Beneficiary Notice of Non-Coverage (ABN) Must be Issued